CHAPTER FIVE

Mental Health Issues

Since the flood my husband has changed in some ways that surprised me. You may or may not have noticed that when we talked about entering our home [after the flood] and the family helping for months, he was fighting back tears. Always before, Gary showed little emotion, even when it was a serious event. Since the flood, he is often moved to tears when others talk about their loss or ours. He never shared much of his service in Vietnam, and we never questioned him. So when this flood came I think it was so overwhelming he had no way to stuff this drastic experience . . . I just find that Gary is softer now. Several of the men in his age group that I have come to know this past year are. It has been a real lifealtering event. Younger people seemed to deal with it differently—I think because they have most of their life ahead of them. Many of us are facing a shorter trip to eternity. It does matter in how decisions are made during such an event. Another mortgage at sixty, seventy, or eighty is almost as scary as facing serious health issues. So we are divided not only by who is a flood victim and who is not but also by age.

—LINDA SEGER, COMMUNITY ACTIVIST AND FLOOD VICTIM1

There were always two moments when people cried during our conversations. The first was when remembering what they saw when they entered their ruined homes for the first time. They had held out a whisper of hope for a miracle, that their prized possessions—a photo album, an antique vase, a family Bible—placed on the kitchen table or even up on the second floor would be spared. Mostly those miracles never happened. But sometimes they did.

Fourteen months after the flood, I sat with Time Check resident Jon Galvin on what remained of his sunroom, basically an exposed plywood deck, outside his abandoned house on Fifth Street NW. The sunroom had been built in February 2008. To decorate the new addition, Jon and his wife, Alice, had found wicker furniture in Iowa City. Then they bought a wrought-iron table with a glass top and chairs and set up a forty-two-inch, flat-screen home theater. All of it was destroyed. His home was classified as “beyond reasonable repair.”

Jon, who would turn seventy in two months, was dressed in cargo pants, a light brown T-shirt, and a blue cap that said “Property of My Family.” His neck was creased with deepset wrinkles, and when we shook hands, I felt as though I was holding a sheet of sandpaper. His hands reminded me of my grandfather’s and the hands of all working men I had known: rough with permanent pockets of grease. Jon picked at his nicks and nails, just as Grandpa always had. His home was a simple structure like so many in the working-class neighborhood of Time Check. Jon had bought it in 1970, and the mortgage payments had been $75 a month. He paid it off in eight years.

We sat with our feet dangling off the edge of the exposed sunroom. Two linden trees shaded us. Jon had planted them thirty years ago to replace the trees he had lost to Dutch elm disease. The yard was lovely. A breeze coming down from the nearby river kept the humidity at bay, but you could still smell the strong, yeasty smell from the nearby Diamond V Mills, an odor I think I remember from my summers in Cedar Rapids in the 1960s. Because the neighborhood was essentially abandoned, the streets were quiet and peaceful.

Jon, who was retired from Amana Refrigeration, told me about his prized collection of carnival glass he had been forced to leave behind during the flood. After ten days of anxious waiting, Jon was allowed back into his house. He was none too pleased that city inspectors who made sure the homes were safe for reentry used sledgehammers to break down his door. (Other residents complained to me, too, about the use of sledgehammers and axes, as if emergency personnel were trying to rescue citizens trapped inside when they knew no one was left.) “The back door is a wooden door; all they had to do is break the window, reach in, and turn the deadbolt.”2

In 1993 the Galvins had forty-one inches of water in their basement. After this latest flood, Alice said she was done with the house. “Twice is enough,” she said. They moved to another part of the city, far from the river. Now, for the first time since 1978, they have a mortgage to pay off.

Jon expected his glass collection to be smashed, but the glass cabinets holding the carnival glass had held up, even though there was seven and half feet of water in the house. “None of the cabinets fell over,” Jon said. “But we had to break the glass in the cabinets in order to get the carnival glass out.”

The pieces that had not been in the cabinets simply floated and then gently embedded themselves in the mud the river left behind. And then there were the kerosene lanterns that floated on the water and came to rest, still standing upright. Just about everything else the Galvins owned was lost. With their daughter’s help, Jon and Alice cleaned off the river goop from every dish and glass. It took two months. Of the thousand pieces, he only lost sixteen.

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The second moment when a resident would cry was when recalling an act of kindness. Jon teared up and looked away when he told me how good his wife’s employer, Coe College, had been to her. “She never lost any pay.”

Vietnam veteran Gary Seger, also a Time Check resident, openly cried when his children pitched in together and bought him a coat for winter. His old coat had been lost in the flood. When he and his wife, Linda, moved back into their rebuilt home, their children and grandchildren presented him with a recliner like the one he had lost in the flood. The kids had always referred to it as “Grandpa’s chair.”

Linda told me that Gary’s tears had “surprised our family, who rarely saw him show emotion. I had always been the one moved to tears. My involvement as an advocate and activist has equally surprised them.

“I just find that Gary is softer now. Several of the men in his age group that I have come to know this past year are. It has been a real life-altering event. Younger people seemed to deal with it differently—I think because they have most of their life ahead of them. Many of us are facing a shorter trip to eternity. It does matter in how decisions are made during such an event. Another mortgage at sixty, seventy, or eighty is almost as scary as facing serious health issues. So we are divided not only by who is a flood victim and who is not but also by age.”

Salvation and maybe even liberation from the past in the midst of chaos was not an entirely obtuse idea. Young leaders did step up and, in many instances, take the lead in flood recovery. Christian Fong was energized by the flood, or at least he found a new calling for his many talents. Chamber of Commerce President Shannon Meyer came to Cedar Rapids six months after the flood because she saw opportunity where many only saw loss. With no experience, Linda Seger became a fiery, unrelenting community leader because her house and neighborhood were flooded.

In Disasters and Mental Health, Charles E. Fritz wrote, “Disasters provide a temporary liberation from the worries, inhibitions, and anxieties associated with the past and future because they force people to concentrate their full attention on immediate moment-to-moment, day-to-day needs within the context of the present realities.”3

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Gary and Linda’s grandson Alex, who was ten when the flood hit, kept a journal of “everything that had happened in that terrifying summer of 2008.” His essay “The Flood Strikes Cedar Rapids” won first prize in the Barnes & Noble Memoir Writing Contest for Fourth and Fifth Grade Students. Three hundred and sixty students entered. Alex, who attends Cleveland Elementary School, noted that his grandparents were evacuated on June 11 and “didn’t get back into their home until June 20.” However, with the help of the Iowa National Guard, Alex’s mother rescued the family cat, Cosmos, on June 13, the day of the crest. Cosmos was hiding under a bed on the second floor.

When he finally saw his grandparents’ flooded home, Alex noted that his skateboard, fishing pole, pictures, and other personal items were piled up in front of the Eighth Street house “along with the rest of the memories.” But he also was an eyewitness to the sorrow of loss.

Furniture was thrown everywhere, and the living room TV was thrown forward and shattered. The refrigerator was tipped sideways. . . . I looked around and saw many of my things covered in black mud. They said it was too hard to save anything. My skateboard, fishing pole, movies, clothes, and my pictures were all piled in front of the house by the street, along with the rest of the memories of my grandparents’ house. I was very sad. Army trucks drove up and down the street. . . . We were all speechless. I was shocked. My little sister cried. My grandma, my mom, and aunts cried. It looked like there had been a war. It smelled really bad, and everybody was wearing masks . . . People were walking around everywhere talking to neighbors. They were all sad. They hugged and cried. People that did not live by my grandma’s house would drive by the houses and point and shake their heads or take pictures. I guess they wanted to remember. I will never forget.4

With so much loss, sadness, and anxiety I began to wonder how the usually stoic Midwesterner was holding up under the stress of a natural disaster. To find out, just after the one-year anniversary of the flood, I met with Dr. Janeta Tansey on the fourth floor of Mercy Hospital, a place also hit hard by the Flood of 2008. In fact, Tim Charles, Mercy’s CEO, had to make one of the hardest professional decisions of his career: to evacuate the hospital’s 176 patients.

Janeta is the attractive, oldest child in a family of eight. Her brother, Christian Fong, is the fourth child. Neither one lacks for confidence. Her husband is a pediatric endocrinologist. They both did their residency at the University of Iowa Medical Center and stayed on as faculty. They live in Iowa City, a liberal university town that has little in common with the grittiness of blue-collar Cedar Rapids, less than thirty miles to the north. Recalling the flood experience in Iowa City, Janeta said, “We were saving libraries not people. It was very different down there.”

The anniversary of the flood was also the one-year anniversary of Janeta’s defense of her PhD thesis on ethics at the University of Iowa. The campus was under siege from the rising waters of the Iowa River, and twenty campus buildings were flooded. On June 15 the Iowa River crested at a record level of 31.53 feet. Two days before, half a million books had been taken out of basement storage at the university’s main library.5

With a historic natural disaster taking place just outside the building where Janeta was defending her thesis, one of her advisors and a good friend of hers walked in and said, “Look, it’s unethical for us to sit here and defend this thesis when there is such overt ethical need in the community.”6

Janeta said the comment provoked an additional level to use in her thesis defense: the very specific need to take care of a community. Still, she continued as committee members took a break from their sandbagging duties, came in to hear her defense, and then returned to the river.

“It was a day with a lot of mixed emotions for me,” Janeta told me, “the exhilaration of finishing but also the awareness of a community that was incredibly detached from my narcissistic focus on finishing my PhD. There was also a sense that in the grand scheme of things, there are more important things than defending one’s scholarship, and it doesn’t have to be today.”

Afterward, Janeta, her husband, Mike, and their sons went down to the river to sandbag. “One of the things I remember during the sandbagging experience was that there was this kind of energy from the ‘Let’s get this done,’ ‘Where are things going?’ people who clearly were organizing at various levels.

“One of the most precious things to me was standing there passing along sandbags and the kind of vigilance people had to one another’s needs. . . . People would say, ‘Oh, you look tired. Let’s do a switch.’ You would see this kind of switching as people tried to make sure nobody was overdoing it.

“You’d hear someone say, ‘You’ve had too much time here. Have a glass of water. Go sit down for a bit.’ That really more intimate level of care was not captured on TV—that extra sense that this is a community that really pulled together and saw strangers as neighbors in a way that, at least for me, really tempered the helplessness of the situation.”

In total, some three million sandbags were used in Iowa City and throughout Johnson County.7

In the months following the flood, Janeta had been in touch with mental health professionals at Mercy and knew they were overwhelmed. They asked if she would help out a couple days a week and try to address the tremendous backlog of patients who needed psychiatric care and had no place to get it.

I told Janeta that I sensed a schizophrenic nature among Cedar Rapidians on the anniversary of the flood. Some people were attending the festivities, but many were boycotting them and seemed to be still in mourning.

“That’s a very typical psychological response to things that people feel very ambivalent about,” she explained. “They’re fearful and anxious but ambivalent in terms of what it means to them and how they are going to move forward. Have they even moved forward?”

As the one-year anniversary neared, Janeta listened as her patients spoke about flashbacks and a sense of hopelessness, dread, and general anxiety. A certain segment of the population didn’t seem to make a full recovery from the flood. Janeta said those people “need some kind of psychiatric care to see if we can get it turned around.” But it wasn’t always easy to tell if patients had a preexisting condition that was made worse by the trauma of the flood.

“Some of them do date their condition back to last summer. Others don’t so clearly make that association, but if you ask them how the flood seemed to affect them they say, ‘Yeah, that was a real difficult time,’ and ‘Yeah, now that you mention it, things have not been good since then.’

“Some patients saw [the flood] as a pivotal event. Others saw it as one more incident in a long litany of events, maybe including a preexisting psychiatric condition, that contributed to the fact that they’re not doing well now.

“Sometimes it’s hard to determine whether it was the flood that pushed them over the edge, if the flood was one of many contributors, or if the flood was a convenient kind of thing to point to.”

I thought of ten-year-old Alex and what kinds of long-term mental health effects he might experience as a result of witnessing his grandparents’ loss. In an article posted a month after the flood by the University of Iowa Health Care Today, Janeta answered the question: “Are we likely to see acute stress disorder and post-traumatic stress disorder in our community?”

“Yes, definitely,” she wrote. “We know from other disasters and shared kinds of trauma that persons of all ages can develop anxiety disorders of many different kinds, including these. It’s important to remember our children, as well. We have many children who, even if they weren’t actually displaced, may have seen a lot of images on TV or talked to friends and family. So it’s important to think of all ages when we’re looking for anxiety disorders.”8

On the other end of the age spectrum, a study published in the Gerontologist found that the elderly do better during floods than younger people. Two researchers used the 1976 Teton Dam collapse in Idaho as a test case to study residents who were sixty-five and older.

When the dam broke, a ten-foot wall of water killed more than 16,000 head of livestock, destroyed 112,484 acres of farmland, and demolished 1,014 homes. The study found that “elderly persons cope quite well with disaster situations and tend to report fewer adverse emotional effects and feeling of relative deprivation than younger victims.” The findings contradicted previous studies that the elderly would suffer because of “a lack of resources, declining physical capabilities, and limited time to replace losses . . . ”

The 1978 study found that the experience of their respondents (two world wars, the Great Depression, the Cold War, and personal traumas) served them well when confronting a new crisis. Even though they “see life as filled with disasters, they have maintained an attitude and orientation appropriate with coping with them.” Seventy percent of those questioned strongly agreed with the statement, “One should never give up hope.”9

When I talked with Dr. Tansey, the residents of Cedar Rapids were only a year past the worst natural disaster in that city’s history. Studies of survivors of the 1993 Mississippi River flood and Hurricane Katrina in 2005 suggested that there were more mental health problems to come in the years ahead.

A study of the 1993 flood just three months out found that 71 percent of respondents were displaying signs of post-traumatic stress and that preexisting health conditions, “particularly anxiety, employment status, and propensity to interpret the flood negatively were significant predictors for high levels of postdisaster stress.”10 (Could people interpret the flood as positive?)

A study published in the Journal of Community Psychology was the result of interviews of ninety-eight people who had been left homeless by the 1993 flood. Researchers contacted them directly after the flood and one year later, asking them to complete a twenty-item Mental Status Index. As might be expected, there was a large increase in emotional distress directly after the flood. That distress dropped a bit one year later, but the levels “remained significantly above pre-flood levels.”11

In a study of 815 residents following Hurricane Katrina published in Molecular Psychiatry, researchers found that post-traumatic stress disorder increased with time. “Contrary to results in other disaster studies, where postdisaster mental disorder typically decreases with time, prevalence increased significantly in the CAG [Hurricane Katrina Community Advisory Group] for PTSD [post-traumatic stress disorder]. . . . Unresolved hurricane-related stresses accounted for large proportions of the inter-temporal increases in severe mental illness, post-traumatic stress disorder, and suicidality.” The study concluded, “High prevalence of hurricane-related mental illness remains widely distributed in the population nearly two years after the hurricane.”12

I thought back to an elderly woman in one of the flooded neighborhoods along the Cedar River. She had been spotted scrubbing river mud from the sides of her gutted house. You could see the line of the floodwaters five feet above the ground, about the height of the woman herself. For two days volunteers had seen her washing furiously, and they had become concerned. They called a mental health professional, who approached cautiously. The counselor started a conversation with the woman, made some small talk, and finally got the courage to say, “Ma’am, I noticed your house has a red placard on it. Do you realize that means it’s probably going to be destroyed?”

“Yes, I understand,” the woman replied. “But I’ve lived here for fifty years. I’ve taken care of this house for fifty years, and I’m not just going to let it just go out of the world. At least it’s not dirty. It’s going to look good.”

The mental health professional left her alone. She kept scrubbing.13